Table 5.10Blood white blood cell count – diagnostic statistics (children of all ages)a

Study; evidence levelYears of data collection; proportion of Haemophilus influenzae type B (Hib); age rangeBlood WBC count thresholdSensitivitySpecificityOR (95% CI) or PPV and NPVb
Dubos, 200862
[EL=III]
1996–2005

Hib: n=7/96

Age range: 1 month to 15.9 years
≥15,000/microlitre48%78%OR=3.4 (95% CI 1.7 to 6.6)
Dubos, 200663 [EL=III]1995–2004

Hib: n=1/21

Age range: 28 days to 16 years
≥15,000/microlitre62%81%OR=7 (95% CI 3 to 22)
De Cauwer, 200735 [EL=III]1997–2005

Hib: n=1/21

Age range: 0 to 15 years
≥15,000/microlitreNot reportedNot reportedNot reported
Sormunen, 199966 [EL=III]1977–1992

Hib: n=23/55c

Age range: 3 months to 15 years
>15,000/microlitre62%85%PPV=58%
NPV=87%
>20,000/microlitre32%97%PPV=79%
NPV=82%
>25,000/microlitre20%100%PPV=100%
NPV=80%
Lembo, 199161 [EL=III]1979–1980 and 1984–1985

Hib: n= 29/46

Age range: 0 to 18.25 years
15,000/microlitre (BM versus AM/EI)22%73%Not reported
a

AM: aseptic meningitis; BM: bacterial meningitis; EI: extrameningeal bacterial infection; WBC: white blood cell

b

OR: odds ratio; NPV: negative predictive value; PPV: positive predictive value

c

All Gram-negative

From: 5, Diagnosis in secondary care

Cover of Bacterial Meningitis and Meningococcal Septicaemia
Bacterial Meningitis and Meningococcal Septicaemia: Management of Bacterial Meningitis and Meningococcal Septicaemia in Children and Young People Younger than 16 Years in Primary and Secondary Care.
NICE Clinical Guidelines, No. 102.
National Collaborating Centre for Women's and Children's Health (UK).
London: RCOG Press; 2010.
Copyright © 2010, Royal College of Obstetricians and Gynaecologists.

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